Foveal Avascular Zone development by OCTA: weighing the influence of Gestational Age and neonatal early growth independently of Retinopathy of Prematurity.

Abstract

Purpose: Focusing the premature birth and its potential complications, this study analyzes Foveal Avascular Zone (FAZ) measured by Optical Coherence Tomography Angiography (OCTA) and its correlation with the severity of prematurity and neonatal growth.

Methods: A cross-sectional comparative study was performed, involving 71 children school-age with history of prematurity and a full-term children control group. Several variables from the neonatal period were collected, such as Gestational Age (GA), Birth Weight (BW), initial Weight Gain (WG) and Retinopathy of Prematurity (ROP). OCTA scans determined FAZ perimeter, circularity, and area on both Superficial Capillary Plexus (SCP) and Deep Capillary Plexus (DCP).

Results: A positive correlation between GA and FAZ area and perimeter was identified, with a smaller FAZ (p<0.001) in preterm children. Furthermore, scatter plots showed a rising trend for all FAZ values based on GA and BW. Thus, children with greater WG during the first 15 days of life had a larger FAZ (p<0.05). GA was also predictive (p<0.001) for FAZ area and perimeter, while the ROP stage was a better predictor (p<0.0232) for its circularity.

Conclusions: OCTA finds discrepancies in FAZ between premature and full-term children, with GA and neonatal growth having a greater influence than ROP itself.